Risk of Metachronous Colorectal Cancer After Segmental or Extended Resection in Patients with Lynch Syndrome.
가이드라인
1/5 보강
PICO 자동 추출 (휴리스틱, conf 2/4)
유사 논문P · Population 대상 환자/모집단
450 patients: 83 (24%) of 350 segmental resection patients, 2 (5%) of 40 extended resection patients, and 3 (5%) of 60 patients who did not undergo surgery.
I · Intervention 중재 / 시술
추출되지 않음
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
[CONCLUSION] For CRC patients with variants in high-risk LS genes, extended resection can significantly reduce the risk of metachronous CRC but does not lengthen overall survival. Segmental resection with close endoscopic surveillance can be a reasonable alternative, given the opportunity for repeat surgery and/or immune checkpoint blockade.
[BACKGROUND] The recommendation for Lynch syndrome (LS) patients to undergo extended colectomy at colorectal cancer (CRC) diagnosis is increasingly controversial due to associated long-term morbidity,
- p-value p < 0.001
- p-value p = 0.006
- 추적기간 7.0 years
APA
Hill MB, Tawantanakorn T, et al. (2026). Risk of Metachronous Colorectal Cancer After Segmental or Extended Resection in Patients with Lynch Syndrome.. Journal of the American College of Surgeons. https://doi.org/10.1097/XCS.0000000000001892
MLA
Hill MB, et al.. "Risk of Metachronous Colorectal Cancer After Segmental or Extended Resection in Patients with Lynch Syndrome.." Journal of the American College of Surgeons, 2026.
PMID
41773741 ↗
Abstract 한글 요약
[BACKGROUND] The recommendation for Lynch syndrome (LS) patients to undergo extended colectomy at colorectal cancer (CRC) diagnosis is increasingly controversial due to associated long-term morbidity, no benefit in overall survival, and recent advances in immunotherapy.
[STUDY DESIGN] A prospective institutional database was queried for LS patients diagnosed with CRC between 1969 and 2024, and rates of metachronous CRC and 10-year overall survival were analyzed.
[RESULTS] Metachronous CRC, with a median of 13 (IQR 5-20) years between diagnoses, occurred in 88 (20%) of 450 patients: 83 (24%) of 350 segmental resection patients, 2 (5%) of 40 extended resection patients, and 3 (5%) of 60 patients who did not undergo surgery. Metachronous CRC was more common in patients with variants in high-risk (MLH1, MSH2) vs low-risk (MSH6, PMS2) genes: 80 (25%) of 326 patients vs. 8 (6%) of 124 patients (p < 0.001). Extended resection was associated with lower rate of metachronous CRC compared with segmental resection in patients with high-risk variants (2 [6%] of 34 vs 75 [30%] of 252; p = 0.006) but not in patients with low-risk variants (0 of 6 vs 8 [8%] of 98; p = 1.00). Ten-year overall survival was 90% (CI, 86% to 93%) for the full cohort (median follow-up, 7.0 years), 89% (CI, 85% to 93%) following segmental resection, and 96% (CI, 88% to 100%) following extended resection.
[CONCLUSION] For CRC patients with variants in high-risk LS genes, extended resection can significantly reduce the risk of metachronous CRC but does not lengthen overall survival. Segmental resection with close endoscopic surveillance can be a reasonable alternative, given the opportunity for repeat surgery and/or immune checkpoint blockade.
[STUDY DESIGN] A prospective institutional database was queried for LS patients diagnosed with CRC between 1969 and 2024, and rates of metachronous CRC and 10-year overall survival were analyzed.
[RESULTS] Metachronous CRC, with a median of 13 (IQR 5-20) years between diagnoses, occurred in 88 (20%) of 450 patients: 83 (24%) of 350 segmental resection patients, 2 (5%) of 40 extended resection patients, and 3 (5%) of 60 patients who did not undergo surgery. Metachronous CRC was more common in patients with variants in high-risk (MLH1, MSH2) vs low-risk (MSH6, PMS2) genes: 80 (25%) of 326 patients vs. 8 (6%) of 124 patients (p < 0.001). Extended resection was associated with lower rate of metachronous CRC compared with segmental resection in patients with high-risk variants (2 [6%] of 34 vs 75 [30%] of 252; p = 0.006) but not in patients with low-risk variants (0 of 6 vs 8 [8%] of 98; p = 1.00). Ten-year overall survival was 90% (CI, 86% to 93%) for the full cohort (median follow-up, 7.0 years), 89% (CI, 85% to 93%) following segmental resection, and 96% (CI, 88% to 100%) following extended resection.
[CONCLUSION] For CRC patients with variants in high-risk LS genes, extended resection can significantly reduce the risk of metachronous CRC but does not lengthen overall survival. Segmental resection with close endoscopic surveillance can be a reasonable alternative, given the opportunity for repeat surgery and/or immune checkpoint blockade.
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같은 제1저자의 인용 많은 논문 (1)
🏷️ 같은 키워드 · 무료전문 — 이 논문 MeSH/keyword 기반
- Pancreatic cancer risk and survival in patients with Lynch syndrome: a nationwide Dutch cohort study.
- The Vital Role of Family Physicians in the Screening and Early Detection of Lynch Syndrome: A Case Report.
- Global Proteomic Analysis of Colorectal Cancers Stratified by Microsatellite Instability Subtype Reveals Protein Differences.
- Effect of a polygenic risk score in patients with late-onset, early-onset, familial, or hereditary colorectal cancer.
- Oncological Genetic Counseling in Hereditary Breast and Ovarian Cancers and Lynch Syndrome High-Risk Subjects: Evaluation of Efficacy and Outcomes Using the Genomics Outcome Scale.
- Risk of Non-colorectal Malignancies in Sporadic Lynch Syndrome-associated dMMR Colorectal Cancer.